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Wednesday, September 16, 2009

Guest Post: Loving daycare

I am an internal medicine intern (9 months of q4 to q5). We live across the street from our daycare. They open at 7 and close at 6 and Luke is generally there during much of their open hours. Since I am a resident, there are many days when dad drops him off and picks him up. I also made the decision to do a residency in the same town as my parents, so that they could help out when we needed them to. We also hire one of the workers there to give us a date night every couple of weeks. Many of my co-residents have nannies, but one plus of the daycare situation is that there are always at least two people watching our baby. And we have everything on video. Another plus is the cost, which is half of what it would cost us to hire a nanny.

We are loving the daycare situation. Both of us were daycare kids so we are personally aware of the pros and cons of daycare. He was 14 weeks when he started, though there are 6 week olds that start there. He is now 8 months old. We pay $800/mo for daycare, a price that decreases as the child gets older. Most good nannies require at least $10/hr, a fair wage if you ask me, but it would be hard for us to afford that with the money we are bringing in. I know people who went into (more) debt to pay for a nanny during residency. Also, there was no daycare at the hospital I work at. A few hospitals in town offer that, and we would consider that, but it is nice not having to drive the child to daycare. Our daycare offers 4:1 supervision, there are some in town that offer 3:1 but they cost more and there is a waiting list. We registered our child there when I was 6 months pregnant to be sure to get a spot. Most places will tell you how far in advance you need to register. I would do it while I was pregnant if you live in a place with relatively few options. Once we have more than one child, the nanny thing might make more sense.

Side note: we use the child care savings account so much of the money for our child care is tax free. Some of the tax incentives for childcare are income dependent and may best apply to those in residency or fellowship.

Another side note: How are you providing health care for your nannies if you have them? Seems like most of the ladies at the daycare where we send our child do not have health care. I think it is crazy that the person you have caring for your child wouldn't even have access to basic services. Anyone have thoughts on that? I am trying to get those who need it into our resident clinic, but it is not easy due to lack of availability.

6 comments:

Oh yeah, we use the FLEX spending as well to use pre-tax money, glad you mentioned that. And I forgot to post about that WAITing list situation! We put our name on a waiting list for a place back when I was pregnant and they called with a spot when my daughter was FOUR AND A HALF YEARS old!!! (I guess we could've used the spot for her 2 year old brother at that point, but we had another great arrangement in place already!)

Regarding the health care, our first nanny had another parttime job that provided her with healthcare. Some can get it through their spouses. Asking parents to pay for their nanny to have health insurance would break the parents. Even very small businesses wouldn't be required to provide health insurance under Obama's new plan, so it seems crazy to think parents should provide it for a nanny.

Regarding the FLEX spending, that's nice, but the amount we're allowed to set aside only covers a fraction of our daycare costs. They need to allow more money to be set aside in certain parts of the country.

We got health insurance provided (at our cost) through the agency that we used to find and hire our Nanny initially; in later years, found an independent health care policy for her. Not cheap, but I felt it was needed.A

Our nanny had Medicaid. And she lived in rent supported housing and (sometimes) had food stamps. She was very proud and sometimes shared her government commodities with us (they were awful). We paid her on the books for tax purposes and a little extra off the books so she wouldn't lose benefits. I also cosigned her care loan and my husband did most of the work when it needed it.

Tramadol is available in both injectable and oral preparations. It is usually marketed as the hydrochloride salt Dosages vary depending on the degree of pain experienced by the patient, and should be decided on the basis of need by the prescriber.

We have always had part-time nannies (in the high 20s hrs per week), even when we worked full-time ourselves, which is a topic for another time. We have never provided health insurance because they were part-time. Fortunately, all had benefits through their spouses, parents, etc. I am all for universal health care. I think anything less is inexcusable in a first world country. But, still, when it's your pocketbook, it is a lot harder to walk the walk.

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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